Give me a P!

Posted by Liz on May 14, 2012 in Uncategorized | 0 comments

P,  as in “progesterone.”

I get a lot of questions on Flashfree about progesterone and whether or not it’s use is as dangerous as estrogen and combined hormone replacement. I have stayed away from the subject for some time now because the evidence has been pretty scarce, at least as far as natural progesterone goes.

Fortunately, a new review has appeared that provides a comfort level for a brief discussion. But is all progesterone alike? A good place to start, right?

Progesterone is a reproductive hormone produced after ovulation and during pregnancy; it is also produced by the nervous system and adrenal glands. It occurs naturally. Progestins are synthetic and manufactured outside the body and work differently depending on their structure. Progestins are often combined with estrogen therapy.

Although experts know that levels of progesterone decline as a woman transitions to menopause, the relation between this decrease and symptoms has not been well understood, thereby limiting practitioner’s — at least those who specialize in Western therapy — ability to make decisions regarding its use in ameliorating symptoms.

Following is what researchers learned by scouring the literature:

• In most cases, progesterone is prescribed as an oral pill ranging from less than 20 mg daily to more than 200 mg daily, or as a patch that delivers more than 50 mg daily. It is also available as a topical cream (the most reliable standardized formulation is manufactured by Emerita (Pro-Gest).
• High dose, oral progesterone and patch forms appear to provide the greatest benefits for lessening hot flashes.
• How well women respond to progesterone patches appear to be related to how severe their symptoms are; those women with the worst symptoms appear to gain the most benefit.
• Use of progesterone may help reduce bone loss, although more studies are needed.
• Use of topical progesterone may possibly help reduce the effects of aging on the skin by increasing elasticity.
• The oral forms have also been shown to hell women whose sleep is disrupted by increasing time spent asleep.
• Most importantly, low dose progesterone treatment, including oral agents, does not appear to increase heart disease risk. Even better? There is some indication that when combined with estrogen, progesterone may counteract negative effects int terms of breast cancer risk. Progesterone formulations also appear to be well tolerated, will only minimal side effects associated with their use.

The key take-away is the natural progestogens (progesterone) appear to safely alleviate  many of the most troubling menopausal symptoms. The rub here is that the evidence for this be fit comes from small studies. Still, it is refreshing to learn that there are safe hormonal options for women who desire that route.